Teens and Tobacco:Exploring the relationship between smoking refusal efficacy, perception of peer's attitudes towards smoking, and smoking status among rural adolescents

Many studies have examined how different factors influence adolescents’ smoking refusal efficacy. What is lacking from this area of research is just how large of a role both smoking refusal efficacy and perceptions of peers’ attitudes about smoking affect smoking status. This study aims to analyze the relationship between refusal efficacy, perception of peers’ attitudes about smoking, and smoking status among rural adolescents.We surveyed 1,059 middle and high school students in rural Georgia. Of the participants surveyed, 51.4% were male, and 48.6% were female. The majority of the participants were white (64.5%).We found that smoking status was negatively correlated with refusal efficacy (r=-.465, p<.001), and positively correlated with perception of others’ attitudes towards smoking (r=.308, p<.001).  Most of the students (91.1%) who had never smoked reported they were definitely sure they could refuse a cigarette when they did not want one. However, of the students that reported that they smoke cigarettes regularly, only 34.4% were definitely sure. Conversely, those students who had never smoked represented 76.1% of the participants that answered definitely sure, and 40% of those who said pretty sure. With respect to attitudes towards smoking, students who had never smoked accounted for 82% of participants who said tobacco use is never a good thing to do, as opposed to current regular smokers, who represented only 1% of people who said tobacco is never a good thing to do. When developing programs focused on teen smoking, it is crucial to include items focusing on smoking refusal efficacy.